How to Prevent and Treat a Trapezius Strain, According to Physical Therapists

Your trapezius muscles (or traps) extend from your neck down to the middle of your back, and across each shoulder blade. The trap is a triangle-shaped muscle that helps you raise your arms and maintain a stable posture when you’re sitting or standing. When you overstretch any part of your trapezius — which consists of an upper, middle, and lower trap — it can lead to a trapezius strain, which can make these motions and positions difficult and cause pain. 

It may seem counterintuitive to exercise if you’re hurting, but gentle, targeted movement of the trapezius is one of the most effective ways to deal with a trapezius strain, says Nandini Rampersaud, PT, DPT, a physical therapist at Hinge Health.

Read on to learn more about what causes trapezius strain, along with how to prevent and treat it — especially with exercises recommended by our Hinge Health physical therapists.

What Is a Trapezius Strain?

Strain refers to a muscle or tendon that’s over-stretched or lengthened, which can happen due to sudden movement, trauma, overuse, or prolonged overexertion, explains Dr. Rampersaud. This can result in an injury to the muscles, which may cause pain and limit range of motion. If you have a trapezius strain, for example, you might feel pain in your shoulder blades and have a hard time lifting your arm on the affected side.

Hearing that you’ve “torn” something in your body can sound alarming, but keep in mind that your muscles and tendons are very resilient and are designed to recover from these kinds of issues that can naturally happen in the course of everyday activities or during exercise.

While strains vary in severity depending on the extent of injury to the pulled muscle or tendon, in most cases, they aren’t serious and can be treated at home with conservative measures.

Symptoms of Trapezius Strain

Symptoms of trapezius strain can vary depending on the severity and where it occurs within the trapezius muscle. Some of the most common symptoms, Dr. Rampersaud says, include: 

• Pain or tenderness along the base of your neck or around your shoulder blades.

• Muscle spasms in or around your trapezius.

• Limited neck, shoulder, or upper back range of motion (for example, difficulty turning your head while driving or looking down while putting on deodorant).

• Muscle fatigue with day-to-day activities.

Trapezius Strain Causes

As with any strain, trapezius strain can happen slowly over time, or suddenly due to a forceful movement. Some of the most common causes of a trapezius strain include: 

• Trapezius overuse. Repetitive lifting or twisting at your job or prolonged exertion during a sport activity can increase the risk of trapezius strain if your body isn’t ready for this level of activity.  

• Staying in one position for too long. There’s no such thing as “perfect” posture. But staying in one position for too long can cause muscle stiffness, which increases the risk of movement feeling forceful without an adequate warmup, explains Dr. Rampersaud. 

• Acute injury. “A sudden, awkward lift or twist, a car accident that causes whiplash, or a fall can cause your trapezius muscle to overstretch, especially if you’re caught off guard,” says Dr. Rampersaud.

• Limited flexibility. Your muscles are like a pulley system. Anytime your muscles don’t move, they become shortened and tight and increase the chances of a strain. That’s why regular movement and targeted exercises are so important. Tight neck and upper back muscles can contribute to a trapezius strain.

Gentle, targeted exercise can help promote muscle balance, which helps a tight muscle become more flexible (and less likely to become strained). Dr. Ramepersaud says exercise also promotes strength, so if your traps are weak and overused, they can start to tolerate more daily demands without fatigue or pain. Movement also increases blood flow and circulation, which can promote healing over time. The above exercises recommended by Hinge Health physical therapists are a great place to start. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatment Options for a Trapezius Strain

A trapezius strain generally resolves on its own with time. But there’s a lot you can do to manage your discomfort and improve your mobility while you heal. 

• Physical therapy. PT can be highly effective in treating a trapezius strain by reducing muscle tension, improving flexibility, and restoring strength. Through targeted exercises, stretching, and sometimes manual therapy techniques, a physical therapist can help relieve pain and prevent further injury. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Prioritize gentle movement. You can increase circulation that promotes healing with gentle movement that doesn’t aggravate your symptoms. “Exercise also helps with the repair process of strained muscle fibers,” says Dr. Rampersaud. If you’re reluctant to move because you think you’ll cause more pain or injury, know this: Movement is often the fastest way to healing. As our Hinge Health care team says, movement is medicine. The reason: You want your muscles and tendons to remain flexible and mobile to prevent more tightness. In order to do that, you need to engage in exercises (like the ones above) that support your healing and strengthen the affected trap muscle to help prevent future injury.

• Apply heat or ice. Using a heating pad or hot pack can help address any stiffness or tightness from a trapezius strain, while ice can be beneficial for soreness or swelling. Ultimately, either works well so choose the option that feels best to you.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for pain from a trapezius strain. It’s important to make sure that you are safely able to take these medications, based on your medical history. 

• Listen to your body. While exercise can help promote healing, you don’t want to exacerbate the injury by pushing yourself too far. The key is to find your “movement sweet spot” that challenges your body and pain system, while simultaneously strengthening muscles and reducing pain. A physical therapist (PT) can help you pinpoint exercises most likely to help your trapezius strain without causing unnecessary pain. 

How to Prevent Trapezius Strains

While it’s not always possible to prevent muscle injury, you can take some simple steps to reduce risk factors that contribute to a trapezius strain, including: 

• Try different lifting techniques. If you're prone to a trap strain or you notice that lifting contributes to your trap pain, consider adjusting how you lift. When you lift something from the floor, for example, keep the weight close to your body and lift with your legs rather than your back. “Don’t bring your shoulders to your ears as you lift, or you could increase your risk of a trapezius strain,” says Dr. Rampersaud.

• Change positions frequently. If you sit all day or perform repetitive movements for your job, switch things up when possible. For example, you could set an alarm to take a stretch break every hour to reduce strain on your trapezius muscles. Or make sure to stretch your traps whenever you get up, whether that’s to go to the bathroom, head to a meeting, or grab your lunch. 

• Create an ergonomic sitting area. At your desk or in your car, try to avoid elevating your shoulders toward your ears. You can do that by adjusting your chair, monitor, or desk height, or moving your steering wheel.

• Exercise regularly. Whether you hit the gym, go on a walk, or do PT exercises, movement keeps your muscles healthy and flexible, which Dr. Rampersaud says can prevent strain with movement.

• Warm up your muscles. Before diving into an intense weight-lifting session, sports activity, or even an afternoon of intense housework, take time to warm up your muscles. A bit of blood flow can go a long way in promoting flexibility and reducing your risk of injury, along with helping your muscles recover after exercise.

PT Tip: Start the Day With a Stretch

Your muscles are more likely to be stiff if you’re in the same position for a long time, like when you’re lying down in bed. Set yourself up for success by stretching for a few minutes when you wake each morning, and make sure to include exercises that stretch your trapezius muscle if you notice more tightness in your upper back and neck area. Your muscles will thank you for the blood flow!

How Hinge Health Can Help You 

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Luijcks, R., Vossen, C. J., Roggeveen, S., van Os, J., Hermens, H. J., & Lousberg, R. (2016). Impact of early life adversity on EMG stress reactivity of the trapezius muscle. Medicine, 95(39), e4745. doi:10.1097/md.0000000000004745

2. Ourieff, J., & Amit Agarwal. (2018, December 6). Anatomy, Back, Trapezius. National Institutes of Health; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK518994/

3. Steffan Wittrup Christensen, Thorvaldur Skuli Palsson, Hans Jørgen Krebs, Graven-Nielsen, T., & Rogerio Pessoto Hirata. (2023). Prolonged slumped sitting causes neck pain and increased axioscapular muscle activity during a computer task in healthy participants – A randomized crossover study. Applied Ergonomics, 110, 104020–104020. doi:10.1016/j.apergo.2023.104020